So far there’s been enough written to where we have been able to figure out that there was something in the scheduling software that employees figured out how to game with “desired” appointment dates and “actual” appointment dates.  Software users will always know more about the software you write than you do as a developer as you try figure every hole that can think of but you never get them all and why beta software exists all over the place.  This sounds from what I have read that the user figured it out, and spread the word. image People do that and talk just like they do on message boards on the web when looking for solutions.  I couldn’t say if I would have caught that years ago myself I developed a scheduling module that went with my EMR and was integrated but I would be mad as hell to find out later that nobody told me so I could fix it, but users do that too.  Once you have been a developer you find all that stuff out.

Again the sad thing is though is that this was written to “help” monitor quality and not to game it.  Also I read where there was no audit trails written on this functionality in the module as well, and I gathered that with the comments I read that “part” of the audit trails were turned off, so in other words the transaction didn’t go to audit trail while in progress and was included when the actual process was done.  That’s the way most software works so if the code module follows standard procedures, then there was no audit trail for a transaction in process as I followed the procedures between a “desired” date and “actual” date, so again there may not be any audits to follow on the “in process” mouse clicks. 

So now I suppose the FBI has stepped in to find out who uncovered the flaw and spread it through the VA grapevine, along with anything else.  I can see a paper record being kept too as if an appointment was changed around, they may need to go back and reference their back steps if working the input between both sides of the module.   Obviously the appointment module needs a fix and that can be done to stop the same type of violations.   I do wonder what the last developers are thinking at this point too, probably mad as well.  You hate for this to happen as a developer as you can’t find everything and users will be users.   As I have read more facilities outside of Phoenix were doing the same thing, so there’s the grapevine reference.

VA Crisis Should Be A Huge Wake Up Call , We Have Turned Into a Nation of “Stat Rats”, Losing Touch With the “Real” World As Virtual Values Confuse, Collide and Wreak Havoc As Models & Formulas Fail

Of course there’s more to to this with an entire culture change and it’s not just VA it goes all the way up to the White House too with culture and you can even pull Cantor into this with the over reliance on stats and models that are failing.  When you saw the initial Phoenix VA interview, all they could talk about were their goals and stats, never mind a left turn to save a life.  Sure some of those goals are good but when you are off balance and just “live” stats and numbers, you forget there’s real world outside of the virtual values and you have that too here.  I see it all the time and tell people with their heads buried in stats and software to take time out and go see how the real worlds is functioning and of course they don’t do enough of that and those folks stick out like sore thumbs with the push,image push, push.  I have heard EMR vendors talk about the revenue cycling people that have no clue on how hard it is for doctors to enter data today, they are just seeing on view and don’t have a clue other than to push a bit too much at times and of course there needs to be balance here.

VA Crisis Just The Tip of the Iceberg As US Needs a Full On Healthcare Culture Change Everywhere To Get Back In Touch With the Real World of Patients…

On another topic too that comes up is the VA ALTHA medical records integration and that’s a tough deal and I’m sure they have burial grounds of HIE software applications and other custom applications they have tried and that takes a while. DOD happens to like their ALTHA system as does some things that VA VistA does not do and has to also be battle field ready too, so you have to think about that but the average consumer doesn't know this at all.  DOD even created an EMR for the White House a few years back too.  So when you read all those stories, think of a project that even more massive than Healthcare.Gov if you will as there are tons of records already there as with Healthcare.Gov you started with clean slates and zero data, bit difference.  Folks, programming is freaking hard and takes time.  So it again appears the FBI might be trying to chase a grapevine here with who said what to who and told who how to do things. 

All seem to think the VA is living in the stone age of medical records and they are not and the video below gives you an idea of what they are doing with technology as well.  BD

FBI Director James Comey confirmed Wednesday that the bureau's Phoenix branch has opened a criminal investigation of the Veterans Affairs Department, amid mounting calls on Capitol Hill for the Justice Department to get more involved.

Comey confirmed the bureau's involvement during a hearing before the House Judiciary Committee. Officials previously made clear that federal prosecutors were helping in an inspector general investigation, but the probe by Phoenix FBI agents marks a new phase.

The additional probe comes as internal audits show the expanding scope of the scandal where thousands of military veterans endured long wait times for VA medical care, and VA officials apparently covered up those wait times in order to make their internal numbers look better.


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